Knowledge, Psychosocial Perception and Therapeutical Attitude about Urinary, Fecal and Flatus Incontinence of Gyneco-Obstetrical Incontinence Origin among Congolese Women
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Abstract
Introduction: Incontinence is defined as the involuntary loss of urine, gas, or stool. This condition is often the consequence of a genital fistula, with repercussions observed across multiple dimensions: psychosocial, emotional, financial, and even professional. This study aimed to describe the knowledge, psychosocial perception, and therapeutic attitudes of women toward urinary, fecal, and/or gas incontinence of gyneco-obstetrical origin in Butembo, Eastern Democratic Republic of Congo.
Material and methods: This was a multicenter, cross-sectional, descriptive study conducted among 362 women in five health facilities in Butembo between March and May 2024. Data were collected using a structured questionnaire and analyzed with SPSS software version 18.0.
Results: Among the 362 women surveyed, 73.4% reported being aware of obstetric fistula. Prolonged labor was identified as the main cause by 59.4% of respondents. Furthermore, 81.58% preferred seeking care from qualified medical personnel, while 18.42% opted for traditional healers or religious leaders. Analysis revealed that belief in a mystical origin reduced the likelihood of hospital consultation (OR = 0.18), whereas identifying obstetric trauma increased this likelihood more than fivefold (OR = 5.86). On the psychosocial level, despite the presence of family support (96.62%), social stigma remained intense: 87.97% of women believed that a patient with fistula should hide from society.
Conclusion: Cognitive and sociocultural barriers strongly influence the therapeutic attitudes of patients suffering from obstetric fistula. Addressing this issue requires destigmatization programs and strengthened psychological support within the community.
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